Angiography Catheter PDF

# Angiography Catheter ### Definition - A catheter is a hollow flexible tube that can be inserted into a body cavity, duct or vessel. - Catheters thereby allow drainage or injection of fluids, distend a passageway or provide access by surgical instruments. - The process of inserting a catheter is c...

# Angiography Catheter ### Definition - A catheter is a hollow flexible tube that can be inserted into a body cavity, duct or vessel. - Catheters thereby allow drainage or injection of fluids, distend a passageway or provide access by surgical instruments. - The process of inserting a catheter is catheterization. - In most cases a catheter is a thin, flexible tube: a "soft" catheter. - In some cases, it is a larger, solid tube: a "hard" catheter. - A range of polymers are used for the construction of catheters, including silicone rubber latex and thermoplastic elastomers. ### Ideal Characteristics - Strength - Radiopacity - Flexible - Low Surface frictional resistance for good tractability over guide wire. ### Parts of a Catheter - **Hub:** a part that can be connected to a syringe or other medical device. - **Body**: the main part of the catheter. - **Tip:** the end of the catheter. ### Measurement - **French catheter scale:** The French catheter scale (FR or Fr) is commonly used to measure the outer diameter of cylindrical medical instruments including catheters, needles etc. - **Chart:** | in | 223 | 21 | 197 | 184 | 17 | 158 | 144 | 131 | 118 | 105 | 092 | 079 | 066 | 053 | 039 | |---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---| | mm | 5.7 | 5.3 | 5.0 | 4.7 | 4.3 | 4.0 | 3.7 | 3.3 | 3.0 | 2.7 | 2.3 | 2.0 | 1.67 | 1.35 | 1 | | Fr | 17 | 16 | 15 | 14 | 13 | 12 | 11 | 10 | 9 | 8 | 7 | 6 | 5 | 4 | 3 | | In | | | | | | | | | | | | | | | | | Fr | 18 | 19 | 20 | 22 | 24 | 26 | 28 | 30 | 32 | 34 | | mm | 6.0 | 6.3 | 6.7 | 7.3 | 8.0 | 8.7 | 9.3 | 10.0 | 10.7 | 11.3 | | In | 236 | 249 | 263 | 288 | 315 | 341 | 367 | 393 | 419 | 445 | - **Most commonly in adult Diagnostic Catheters of 5 – 7 Fr is used.** ### Types of Catheters #### Holes - **Side holes:** - Single Hole - End Hole with side holes - Blocked end with side holes only - **The more holes at the end:** - More contrast used - Large vessels - **Catheter with only end hole:** - Smaller vessels/ carotid - **Combo end and side holes reduce risk of trauma to vessel, enhances contrast.** #### Sizes - Sizes: - Abdominal – 6-80 cm - Thoracic or Carotid Arteries – 100-120 cm - NOTE: Size depends on: - age of the patient - selective or super selective study - size of the vessels #### Shapes - **Straight Catheter:** end hole only - **Pigtailed Catheter:** - Circular tip w/ multiple side holes to reduce whiplash and control contrast - Allows higher volumes of contrast to be injected. - **Cobra Shaped Catheter:** - variation in curvature to facilitate selection of vessels - **Side Winder Catheters (Shepherd):** - curved to facilitate vessel selection - **Varieties of catheters:** - Headhunter - Cobra - Sidewinder #### Catheter Types - **Flush catheters:** - Are typically used for aortic injections - Have multiple side holes near the tip to allow for a rapid high- volume injection to opacify the large diameter vessel. - **Selective catheters:** - Contain only a single end hole and have no side holes. - **Angioplasty Catheters:** - Specialized catheters with a balloon placed near its leading end to allow for dilation of Stenosis. - The balloon is inflated through a side port and typically connected to a pressure gauge. - **Intermittent Catheters:** - Intermittent catheters are hollow tubes used to drain urine from the bladder. - **Pediatric Catheters:** - Usually, its around 80cm. - **Diagnostic catheters:** - Used for Angiographs . - **Guiding catheters:** - Used for Angioplasty. - **Balloon Catheters:** - Foleys Catheter (1way, 2way or 3way) - Butterfly Catheters # Puncture Needles - Used to cannulate or puncture the artery. - Usual Sizes include: - 18 ga, 19 ga, 20ga, 21 ga. - The selection of the Size depends on the guide wire going to be inserted through that needle port. # Guide Wire - **Diagnostic guide wires** are used to traverse vascular anatomy to aid in placing catheters and other devices. - **Guide wires** are used for both Cardiology and Radiology angiographic procedures. - **Guide wires** are metallic or plastic wires that serve two general roles: exchange and guidance within a vessel or lumen. - **Shape of the Tip:** J Tip / Straight Tip # Stents - Stents are metallic cylindrical devices that are placed within a vessel or other lumen to provide a scaffolding to decrease the likelihood of recurrent Stenosis. - Stents can be made of bare metal or can be covered with a fabric(Covered stent or stent graft). - A.Left to right: two types of graft covered self-expandable stents (stent grafts); a bare metal self-expandable stent in the center; and a pair of balloon stents. - B.Endovascular stent grafts for abdominal aortic aneurysm repair. # Embolic Materials - Various materials can be delivered through a catheter to purposely occlude a specific vessel or deliver a specific therapeutic agent. - Curled metallic wires with or without embedded fibers called embolization coils are delivered by pushing the coil through a catheter with a guide wire - Poly vinyl alcohol (PVA) beads, ranging in size from 50 to 1,000 µm, are often used for tumor embolization. - A.Poly vinyl alcohol (PVA) particles. - B.Embolization coils. - C.Detachable vascular plug. # Percutaneous Ablation Devices - These are specialized instruments for ablating tumors in the liver, kidney, lung,and bone percutaneously. - These devices are used to freeze(Cryoablation)or burn(Radiofrequency ablation and Microwave ablation)tumors. - These devices include biopsy needles, vena cava filters, drainage catheters, and venous access devices. - A.Probe with electrodes retracted. - B.Tip of probe with electrodes deployed. These are placed directly into the lesion. # Uses & Applications of Catheters - Placement of a catheter into a particular part of the body may allow: - Draining urine from the urinary bladder as in urinary catheterization, e.g., the Foley catheter. - Drainage of urine from the kidney pelvis by percutaneous nephrostomy. - Drainage of fluid collections, e.g. an abdominal abscess. - Administration of intravenous fluids, medication or parenteral nutrition with a peripheral venous catheter. - Angioplasty, angiography, balloon septostomy, balloon angioplasty. Often Seldinger technique is used. - Administration of anesthetic medication into the epidural space, the subarachnoid space, or around a major nerve bundle such as the brachial plexus. - A central venous catheter is a conduit for giving drugs or fluids into a large-bore catheter positioned either in a vein near the heart or just inside the atrium. - A Swan - Ganz catheter is a special type of catheter placed into the pulmonary artery for measuring pressures in the heart. # Conclusion All students will be selected for assignments.